ALS companies in the Bay Area

DrParasite

The fire extinguisher is not just for show
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@E tank , That makes sense; I believe Seattle does the same thing.

and I can understand having a tiered system, where the paramedics only transport ALS patients, and BLS handle the rest.... but it looked like SJFD and SCCFD send an equally qualified ambulance to the commercial one, but they only transport as a last ditch effort.
 

E tank

Caution: Paralyzing Agent
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@E tank , That makes sense; I believe Seattle does the same thing.

and I can understand having a tiered system, where the paramedics only transport ALS patients, and BLS handle the rest.... but it looked like SJFD and SCCFD send an equally qualified ambulance to the commercial one, but they only transport as a last ditch effort.

I see what you're saying...did not realize that. No...that doesn't add up....
 

Aprz

The New Beach Medic
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That is correct. Two ALS ambulances are sent, one by the fire department and the other is the private contractor. The fire department does not transport unless last ditch effort. This is not the norm throughout the entire county, but only in certain cities/parts.

To be fair, it is less of a waste than sending a fire engine.

I'm not sure if they get charged or not. Part of the contract requires the private ambulance contractor to restock the fire department so the patient gets charged for any equipment the fire department uses even if the treatment isn't continued by the private contractor ambulance. I know they get charged for fire's treatment when the private ambulance transport, but not sure if they still do when the fire department transports.
 

hometownmedic5

Forum Asst. Chief
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That is correct. Two ALS ambulances are sent, one by the fire department and the other is the private contractor. The fire department does not transport unless last ditch effort. This is not the norm throughout the entire county, but only in certain cities/parts.

To be fair, it is less of a waste than sending a fire engine.

I'm not sure if they get charged or not. Part of the contract requires the private ambulance contractor to restock the fire department so the patient gets charged for any equipment the fire department uses even if the treatment isn't continued by the private contractor ambulance. I know they get charged for fire's treatment when the private ambulance transport, but not sure if they still do when the fire department transports.

I bet you can hear the caterwauling from the fire guys when they have to transport from three counties away...
 

DrParasite

The fire extinguisher is not just for show
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That is correct. Two ALS ambulances are sent, one by the fire department and the other is the private contractor. The fire department does not transport unless last ditch effort. This is not the norm throughout the entire county, but only in certain cities/parts.
so why not just have the FD transport? patient is at the hospital quicker, the city can get the insurance revenue, and no need to even have a private service, except during peak times. sounds grossly inefficient. in fact, if my loved one had a medical emergency, and the FD ambulance just sat outside while my loved one was dying, I'd file a lawsuit in an instant (and of course, every emergency is life threatening, so there is some hyperbole, but you get the idea).
To be fair, it is less of a waste than sending a fire engine.
without getting off on too much of a tangent, no it's not, at least not in all situations. And I won't even go into the waste of having ALS suppression units or ALS FD first responders......

If I have a three man engine company, and two hop on the ambulance for an EMS run, than that engine company is pretty much OOS until they return. If it's a 4 man engine company, that engine company is running short (can't do much as a single FF, since the driver is chained to the pump panel). if it's a 5 or 6 man company, than i'm jealous of your staffing numbers.

So if I send the engine with 3 people, yes, that engine is OOS for other calls, but once the ambulance arrives, the engine can go back in service, and is ready for the next cal. If I send all 4, same results.

If the engine has 4 guys, and I put two of them on a QRV/Brush truck/mini pumper, the engine might stay in service (short), and the first response vehicle is cheaper than an engine. Should a second EMS call occur in their first due, the engine can response. And when Joe Public asks why they aren't taking their loved one to the hospital, "it's not a vehicle designed for patient transport."

My department run a 3 man engine in the city to all calls. At our station in the county, we send a QRV for EMS calls with 2 personnel, and the captain stays behind in case their is another call. if another EMS call comes in, he or she will take the brush truck. We are a BLS department, while EMS is entirely ALS. So having us run an ambulance, especially outside of the urban area, doesn't really make a lot of sense.

While an ambulance is cheaper than an engine, a pickup truck or SUV is a much cheaper first responder vehicle than a fully stocked ambulance.
I'm not sure if they get charged or not. Part of the contract requires the private ambulance contractor to restock the fire department so the patient gets charged for any equipment the fire department uses even if the treatment isn't continued by the private contractor ambulance. I know they get charged for fire's treatment when the private ambulance transport, but not sure if they still do when the fire department transports.
restocking the FD is pretty common, esp for disposable equipment (NRBs and such). I'd be curious to see how they document a chart, and justify billing for a service that they didn't provide (since the FD did it, not them), especially if its not a treatment they are continuing, like continuing to apply oxygen via NRB. but that's a different topic altogether..
 

Aprz

The New Beach Medic
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Oh, the fire ambulances here are a separate crew/schedule from the Engine. The Engine does not go down when the ambulance goes to call. Personally, I think fire to EMS calls is a 100% waste no matter what, so sending less people and a smaller vehicle is less of a waste in my eyes even if it did put an Engine out of service (it doesn't), but I know this has been argued to death on here, and we don't need to beat that dead horse again.

It isn't service they are charged, but the equipment. The firefighters used my non rebreather? That'll be $250 please.

I believe the fire department does want to transport, but because they refuse to serve the county outside of their own city, the county does not allow them unless desparate. I think it hasn't been a problem because the ambulance is held to nearly the same as fire with response times in that county, so in that area, the ambulance is frequently first on scene, arriving the same time, or at worst arriving a couple of minutes (3 minutes later before they are considered late I think) after when fire is still trying to figure out the patient's name. For the record, San Jose Fire Department made the news for not getting reimbursed by the county for calls because they were not meeting their 90% on time response time (city aimed for 80%) while the private ambulance was held to a standard of >90% (I was trying to find a good article on this, but couldn't on my phone, it was huge news in the area at the time). They are allowed to transport if the patient is inextremis/I think maybe even "critical" if the ambulance ETA is late.
 

Jim37F

Forum Deputy Chief
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You think that's bad, when I worked for McCormick back down in LA, there were a few FDs that operated fully staffed ALS ambulances (2 fire/medics, full compliment of ALS gear, gurney, full transport capability), as squads. As in us in the BLS ambulance would respond with them, and if they determined the patient needed ALS transport? The patient was loaded into the BLS ambulance, 1 EMT driving, the other in the back, alongside one of the fire/medics whi brought their monitor and drug box, and we'd transport that way with the other medic driving their squad behind us to the hospital...

Only in cases of extremis where we weren't on scene and/or a FF down case would they transport themselves.

One of the Depts that did that with us was doing it's own ALS transport in those ambos, and had hired single role EMTs to staff BLS units (an Engine would respond with either the medic ALS unit, or the single role EMT BLS unit... but then they shut down their BLS program, renamed their ALS ambulances to Squads and contracted with McCormick and now send an Engine, Squad, and McCormick BLS to every call...

So yeah, Bay Area still making slightly more sense than LA (in that regard at least lol)
 

DrParasite

The fire extinguisher is not just for show
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Oh, the fire ambulances here are a separate crew/schedule from the Engine. The Engine does not go down when the ambulance goes to call. Personally, I think fire to EMS calls is a 100% waste no matter what, so sending less people and a smaller vehicle is less of a waste in my eyes even if it did put an Engine out of service (it doesn't), but I know this has been argued to death on here, and we don't need to beat that dead horse again.
wait, so those two guys on the non-transporting ambulance are assigned to the EMS unit for the duration of the shift? so if they do transport, it's not like their is any loss in fire coverage? I'm surprised the county hasn't proposed to cut funding for the non-transporting ambulance, especially if the private services arrives at the same time.
I believe the fire department does want to transport, but because they refuse to serve the county outside of their own city, the county does not allow them unless desparate.
Ok, that actually makes sense. It's still grossly wasteful on the side of the city, but municipalities (in general) are really good at wanting to protect their area first, and not areas that don't pay city taxes.
I think it hasn't been a problem because the ambulance is held to nearly the same as fire with response times in that county, so in that area, the ambulance is frequently first on scene, arriving the same time, or at worst arriving a couple of minutes (3 minutes later before they are considered late I think) after when fire is still trying to figure out the patient's name.
it's a gross duplication of resources, adds to the taxpayer's burden, while not providing any real benefit. and I'm sure every private ambulance employee is looking to get hired by the FD so they can make triple the salary for the same work.
For the record, San Jose Fire Department made the news for not getting reimbursed by the county for calls because they were not meeting their 90% on time response time (city aimed for 80%) while the private ambulance was held to a standard of >90% (I was trying to find a good article on this, but couldn't on my phone, it was huge news in the area at the time). They are allowed to transport if the patient is inextremis/I think maybe even "critical" if the ambulance ETA is late.
you mean this one? https://www.nbcbayarea.com/news/loc...-Response-Times-Under-Scrutiny-242496361.html
What a mess....
That was my thinking as well.
 

Aprz

The New Beach Medic
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The county pays them to be first response, have really strict response time standards and severe fines for the private ambulance company kind of making fire/first response useless in my opinion. Anyways, the county doesn't care if it is a fire engine, QRV, ambulance, etc.. They are paid for first response.

A lot if people want to go fire like usual, but our pay and benefits are actually OK. Some people switching to fire, especially San Jose Fire, take a pay cut. I am paid $41.93/hour working a 10/40 shift on one of my local private ambulance companies here. You have to go to a fancier Fire Department like Santa Clara City.
 
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